Prevalence of depression and associated factors among tuberculosis patients in primary care in the district of Kuching, Sarawak

Depression in tuberculosis (TB) increases the risks of adverse health outcomes. However, little is known about depression in tuberculosis patients in Malaysia. The aim of this study was to determine the prevalence and associated factors of depression in tuberculosis patients in primary care clinics. A cross-sectional study was adapted for this study. A total of 235 TB patients were recruited in six primary care clinics in the district of Kuching, Sarawak in Malaysia using convenience sampling method. A self-administered questionnaire, Patient Health Questionnaire-9 (PHQ-9), was used to screen for depression, and social support was accessed using Multidimensional Scale of Perceived Social Support, MSPSS. This study showed that the prevalence of depression among TB patients was 7.7%. Socio-demographic factors, tuberculosis-related clinical data and social support are not significantly associated with participant’s depressive states. Findings also showed that there is no different in terms of social support received by depressive and non-depressive tuberculosis patients. Conclusively, depression in TB patients is considered low; however, screening for depression in TB patients should not be neglected because it can lead to better treatment outcomes

Explorative survey on the usage and needs of Mobile Health Applications (mhealth) amongst caregivers in taking care of stroke survivors

Mobile health (mHealth) applications may assist stroke caregivers in answering the unmet needs of inadequate information and support from healthcare professionals. This study aimed to explore the usage and needs of mHealth applications among stroke caregivers and its associated factors. This cross-sectional study involved 207 stroke caregivers attending hospital and community-based stroke clinics in Kuala Lumpur between December 2020 until March 2021. The survey was done through newly developed self-administered bilingual questionnaires using face to face interviews, telephone interviews and Google form. Most caregivers (77.8%) used at least one mHealth application for self-care or during the caregiving process. The three most types of mHealth applications were contacting healthcare professionals (89.9%), disease monitoring (89.4%) and health information (89.4%). The three most features of mHealth applications were free to download/use (94.7%), simple interface (93.7%) and data security/privacy (93.7%). Chi-square test of association showed managing appointment (χ2 (1) = 5.65, p = 0.017), health information (χ2 (1) = 6.72, p = 0.01), disease monitoring (χ2 (1) = 9.58, p = 0.002), contacting healthcare professional (χ2 (1) = 6.27, p = 0.012) and patient disability level (χ2 (1) = 4.29, p = 0.038) were significantly associated with specific types of mHealth applications. In conclusion, the overall usage of mHealth applications among stroke caregivers was high, with the need of specific types and features in mHealth applications among stroke caregivers

Stroke survivors' and informal caregivers' experiences of primary care and community healthcare services - A systematic review and meta-ethnography.

OBJECTIVE: To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. DESIGN: Systematic review and meta-ethnography. DATA SOURCES: Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). ELIGIBILITY CRITERIA: Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. DATA SYNTHESIS: A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. RESULTS: 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. LIMITATIONS: Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. CONCLUSIONS: Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not have the knowledge or skills to re-engage. This can be addressed by: (1) increasing stroke specific health literacy by targeted and timely information provision, and (2) improving continuity of care between specialist and generalist services. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO 2015:CRD42015026602

Prevalence of needle stick injuries and compliance to infection control guidelines among health care workers in a teaching hospital, Malaysia

Introduction: Health care workers (HCW) are constantly exposed to blood-borne illnesses through needle stick injuries (NSI). Despite the increasing trend of NSI, evidence regarding the actual practice of universal precautions among these HCWs is lacking. This study assessed the practice of universal precautions towards prevention of NSI among HCWs in a teaching hospital setting. Methods: This cross-sectional survey involved a newly-designed self-completed questionnaire assessing demographic data, exposure to NSI and practice of universal precautions. Questionnaires were distributed to every ward and completed questionnaires were collected after a period of 7 days. Results: A total of 215 HCWs responded to the survey. 35.8% were exposed to bodily fluid, with 22.3% had NSI in the last 12 months. Blood taking was the commonest procedure associated with NSI. Of practices of universal precautions, recapping needle and removing needle from syringe were still wrongly practiced by the HCWs assessed. Conclusion: NSI among HCW are still common despite the introduction of universal precautions in our hospital. Incorrect practices in handling sharps should be looked into in order to reduce the incidence of blood-borne illnesses through NSI in the hospital

Clinical features and risk factors for HIV encephalopathy in children

A prospective cohort study was conducted to determine the incidence of progressive encephalopathy (PE) and its associated clinical manifestations amongst a cohort of HIV infected children attending the HIV/AIDS clinic of the Pediatric Institute, Kuala Lumpur Hospital, Malaysia. Neurological and neurobehavioral assessments were performed in 55 children with HIV over a 24-month study period. Parameters assessed were physical and neurological assessments, CD4 counts, CD4 percentages, RNA viral loads and an IQ assessment at four monthly intervals. PE was diagnosed when patient developed at least one of the definitive criteria for PE based on the Consensus of Pediatric Neurology / Psychology Working Group, AIDS Clinical Trial 1996. The incidence of encephalopathy was 18.2% (n=10) in 2002. All the patients had hepatosplenomegaly, lymphadenopathy, abnormal deep tendon reflexes and five had impairment in brain growth. The CD4 counts and CD4 percentages were more likely to be associated with PE compared to the non-PE group

A malnourished post-stroke man with multi-morbidity and sarcopenia risk in a long-term stroke clinic: A case report

A 78-year-old post-stroke man with multiple comorbidities who was activity of daily living-dependent developed aspiration pneumonia associated with nasogastric tube (NGT) blockage. He presented with malnutrition and risk of sarcopenia with hypoalbuminaemia, small calf circumference (CC), low body mass index and small mid upper arm circumference. He showed symptoms of moderate-to-severe vascular dementia with behavioural psychological stress disorder, resulting in carer stress. Psychoeducation among the carers and referral to a neuro-psychiatrist were ensued after outpatient-based team meeting discussion. Herein, we highlight the importance of screening for sarcopenia and nutritional status in post-stroke patients with the use of the CC and serum albumin level as well as the involvement of a multidisciplinary team in the primary care setting to improve patient outcomes. Percutaneous endoscopic gastrostomy tubes are more suitable than NGTs for post-stroke patients who require enteral feeding to improve the nutritional status

Synthesis and surface modification of biocompatible water soluble core-shell quantum dots

In this study, the applications of CdSe/ZnS quantum dots (QDs) and its role in advanced sensings has been explored. The CdSe/ZnS was synthesized by using hot injection method with the shell ZnS layer was made using successive ionic layer adsorption and reaction (SILAR) method. The morphology of the CdSe/ZnS QDs was studied using Transmission Electron Microscope (TEM) and the average particle size was in 10-12 nm range. The prepared QDs were optically characterized using spectrofluorescence and strong emission was observed at 620 nm. Comparison of the fluorescence emissions of CdSe/ZnS capped with various capping ligands such as L-cysteine, thioglycolic acid (TGA), mercaptopropionic acid (MPA), mercaptosuccinic acid (MSA) and mercaptoundecanoic acid (MUA) were studied. The CdSe/ZnS capped with TGA gave the strongest fluorescence emission compared to others

Bus tracking app for universities transportation

Shuttle buses have become an important means of transportation for students especially for those who rely on it to go to class. However, students often face difficulty knowing the current location of the bus and its estimated arrival time. Some of them are even unaware of the bus schedule provided by higher management. Consequently, they have to wait too long for their respective buses to arrive. Hence, for the convenience of those who want to plan their journey with shuttle buses, two applications are proposed. One application will track the location of the bus and the other application will be used by the students. Both proposed applications will be used along with an Android phone since it is mostly used by students. The main objectives of developing this application are to inform users regarding the current bus location and estimated arrival time. This application also provides users real-time forum so they can start conversations with others with the same application. Besides, the driver's profile is also included for the user's future reference

Upper Limbs Extension and Flexion Angles Calculation and Visualization Using Two Wearable Inertial Measurement Units

Human motion analysis is widely used in many fields such as physical rehabilitation, athlete training, health status diagnosis and many others. Range of motion (ROM) is an important parameter to evaluate limb’s performance during activity of daily. Goniometer is a device often used by physiotherapist to evaluate and analyse the ROM of individual’s limb movement. The objective of this works is to develop a system to measure ROM using multiple Inertial Measurement Units (IMU) and transfer data to host computer by using Bluetooth Low Energy (BLE). A software program was develop using Phyton to visualize the motion. In this works, Intel CurieNano board, a six degree of freedom IMU that consist of an accelerometer and a gyroscope was used to calculate the ROM using sensor fusion algorithm. The data from accelerometer and gyroscope were fused using the complementary filter to get the ROM. The motion data was acquired by IMU sensor was sent to a custom program developed in Python through BLE. This custom program displayed the acquired data and visualized the motion in 3D visual model

Factors influencing H1N1 vaccination among primary health care workers: A cross-sectional study

Background: Primary health care workers (PHCW) are the front-liners in any infectious disease outbreaks. The recent outbreak of H1N1 influenza demonstrated that uptake of H1N1 vaccination remained low amongst PCHW despite its proven effectiveness. This trend is worrying as PHCW are the first point of contact in any emerging outbreak of future influenza epidemic. To investigate factors influencing willingness of H1N1 vaccination amongst PHCW. Methods: A cross-sectional survey using self-reported questionnaire assessing perception and practice towards H1N1 Influenza A vaccination. A score of 34/50 was used as a cut-off score that divide good and poor perception. Logistic regression analysis used to explore the association between acceptance to be vaccinated and chosen variables. Results: The mean age was 33.91 (SD: 8.20) with mean year of service of 9.23 (SD: 8.0). Acceptance of H1N1 vaccination was 86.3%. A total of 85.9% perceived the vaccination can prevent serious disease. Willingness to be vaccinated influenced by perception at risk of having illness (OR: 10.182, CI: 1.64-63.23, P 0.013) and need for vaccination (OR: 11.35, CI: 4.67-27.56, P < 0.0001). Conclusions: PCHW were generally willing to be vaccinated should H1N1 Influenza epidemic emerges in the future. However, acceptance of vaccination was influenced by factors of benefit to prevent illness and reduction of spread of the illness. Fear of side-effects remained a barrier toward acceptance which should be taken into account in planning of preparation for future wave of outbreak